Synchronous squamous cell carcinoma of the kidney, squamous cell carcinoma of the ureter, and sarcomatoid carcinoma of the urinary bladder: A case report

Primary squamous cell carcinoma of the kidney with hepatic invasion

Introduction

Primary squamous cell carcinoma of the kidney is rare, with only a few cases reported to date.

Case presentation

A right renal mass was detected in a 73-year-old asymptomatic man. Dynamic contrast-enhanced computed tomography showed a hypodensity mass extending from the upper pole of the kidney to the right lobe of the liver. Renal biopsy revealed that this tumor was squamous cell carcinoma. One month later, computed tomography showed rapid tumor growth. Radical nephrectomy and partial hepatic resection were performed. Pathological analysis indicated that this tumor originated from the tubular epithelium, and the patient was diagnosed with primary squamous cell carcinoma of the kidney.Following up without adjuvant therapy, he developed retroperitoneal recurrence and multiple lung metastases and expired.

Conclusion

In this case, squamous cell carcinoma of the kidney invaded the liver and progressed rapidly. Considering these observations, surgical resection should be promptly performed in suspected cases.

Primary squamous cell carcinoma of renal parenchyma: A case report and literature review

Rationale

Primary renal parenchymal squamous cell carcinoma (SCC) is an extremely rare tumor that is difficult to diagnose by hematology and imaging studies and is often diagnosed later than other primary renal cancers.

Diagnosis

A 52-year-old male patient was found to have cysts in both kidneys for 1 week. No urgency and frequency of urination, no dysuria, no gross hematuria, and no significant changes in recent body weight were reported.

Interventions

The upper pole of the right kidney is a cystic and solid mass (8.3 cm * 8.2 cm * 8.1 cm), the cystic part has long T1 and long T2 signals, the solid part has mixed signals, and some parts have limited diffusion. There were nodular long T1 and short T2 calcification signals. An enhanced scan of the solid part showed uneven enhancement and continuous enhancement of the mass capsule. Cystic renal cancer was considered because of the multiple cysts in both kidneys. Surgical treatment was performed. Postoperative pathology revealed well-differentiated squamous cell carcinoma of the right kidney with cystic degeneration, 8.5 cm * 6 cm in size, infiltrating the renal parenchyma, and the cutting edge was negative. The pathological stage was pT2bN0M0.

Outcome

At the follow-up 5 months after the operation, no metastasis was found.

Conclusion

Renal SCC is rare and easily misdiagnosed and missed. Pathological diagnosis is still the gold standard for its diagnosis. However, with active surgical treatment, the short-term prognosis of the patient is good.

A case report: a renal squamous cell carcinoma presenting as a nephrocutaneous fistula

Background

Primary renal squamous cell carcinoma is a scarce entity, and its presentation as a discharging sinus is still exceptionally rare. We hereby report a case of a renal cell carcinoma in a young gentleman.

Case presentation

We report a case of a 20-year-old gentleman who presented with clinical features suggestive of left side xanthogranulomatous pyelonephritis (XGPN). He had undergone multiple endourological procedures for left side renal calculi in the past. We present the clinical presentation, diagnostic dilemmas and treatment for this patient. We performed an open radical nephrectomy for this patient. Our case report is unique from the point of view of nature of presentation to the final histopathological outcome in terms of age group of the patient.

Here we present the clinical management and dilemmas in the management of this unusual and rare case.

Conclusions

Our case report and presentation has taught us that we as clinicians must have a high index of suspicion for a renal malignancy when treating patients who present with pyonephrosis associated with long-standing calculi diseases, irrespective of the age group of the patient.

Primary squamous cell carcinoma of the kidney parenchyma with ascending colon invasion: A case report and literature review

INTRODUCTION

Primary squamous cell carcinoma (SCC) of the kidney parenchyma is extremely rare, with only seven cases reported to date. Herein, we present a case of primary with colon invasion.

PRESENTATION OF CASE

A 61-year-old man presented right flank pain for 5 months. Computed tomography (CT) showed multiple renal stones and a necrotic mass in the lower pole of the right kidney, which was suspicious for ascending colon invasion. There was no history of radiation or occupational exposure to chemicals. Radical nephrectomy, right hemicolectomy, and lymph node dissection were performed. The kidneys showed a solid mass with multiple renal stones. The tumor comprised nests of atypical squamous cells and keratin pearls; however, the renal pelvis was normal. 18-Fluorodeoxyglucose-positron emission tomography/CT failed to demonstrate other primary site. Therefore, the patient was diagnosed as primary SCC of the kidney. The patient did not receive adjuvant therapy and was alive during follow-up for 6 months after surgery.

DISCUSSION

SCC of the urinary tract is considered to be the result of squamous metaplasia of the urothelium, which may potentially progress to SCC. Squamous metaplasia may be caused by chronic irritation. However, the mechanism of SCC remains unclear. Although the prognosis of SCC is similar to that of urothelial carcinoma when compared stage for stage, SCC tends to be diagnosed at a more advanced stage.

CONCLUSION

This is a rare case of kidney SCC with adjacent organ invasion. Additional studies are required to further our understanding of this rare tumor and improve diagnosis and treatment.

Squamous cell carcinoma of the renal parenchyma presenting as hydronephrosis: a case report and review of the recent literature

BACKGROUND

Primary squamous cell carcinoma of the renal parenchyma is extremely rare, only 5 cases were reported.

CASE PRESENTATION

We probably report the fifth case of primary Squamous cell carcinoma (SCC) of the renal parenchyma in a 61-year-old female presenting with intermittent distending pain for 2 months. Contrast-enhanced computed tomography (CECT) revealed hydronephrosis of the right kidney, but a tumor cannot be excluded completely. Finally, nephrectomy was performed, and histological analysis determined that the diagnosis was kidney parenchyma squamous cell carcinoma involving perinephric adipose tissue.

CONCLUSIONS

The present case emphasizes that it is difficult to make an accurate preoperative diagnosis with the presentation of hidden malignancy, such as hydronephrosis.

Upper urinary tract urothelial carcinoma and its variants: transition from morphology to personalized molecular characterization in diagnosis, prognosis, and therapy

INTRODUCTION

Upper tract urothelial carcinoma (UTUC) accounts for 5% of urothelial carcinomas (UCs), the estimated annual incidence being 1-2 cases per 100,000 inhabitants. The aim of this review was to summarize the main morphologic features of UTUC as well as the current status and future role of its molecular characterization in diagnosis, prognosis, and therapy. Areas covered: Several studies on the UTUCs have shown the diagnostic, prognostic, and therapeutic significance of standard pathological features, such as tumor stage, grade, and lymph node metastasis. Investigations have also identified novel factors, in particular, variant histologies, and molecular biomarkers. Based on these, predictive tools have been developed. Expert commentary: The morphology of the UTUC has been considered to be the same as that of Bladder Urothelial carcinoma (BUC). Molecular characterization studies, including genomics, have shown changes in UTUC occurring at differing frequencies in comparison with BUC, the former with unique molecular subtypes and different responses to treatment.

Biological role and clinical value of miR-99a-5p in head and neck squamous cell carcinoma (HNSCC): A bioinformatics-based study

MicroRNAs (miRNAs) are confirmed to be tumor promoters or suppressors in multiple squamous cell carcinomas (SCCs). miR‐99a‐5p has been demonstrated to be downregulated in cancerous tissues, but its functional role in head and neck SCC (HNSCC) and its mechanism of action have not been fully elucidated. Here, we studied the expression of miR‐99a‐5p in HNSCC and performed a clinical value assessment and then extracted mature expression data from The Cancer Genome Atlas (TCGA) and microarrays from Gene Expression Omnibus (GEO). Furthermore, biological analysis was constructed via online prediction tools. The results revealed that miR‐99a‐5p expression was markedly lower in HNSCC tissues than in normal tissues, which also showed significance in the prognosis of HNSCC. However, its diagnostic value could not be verified due to the lack of body fluid samples. Additionally, miR‐99a‐5p was expressed at higher levels in patients with low histological grade neoplasms than those with high histological grade neoplasms. The age of the patient might also be a possible clinical parameter affecting miR‐99a‐5p expression. Furthermore, miR‐99a‐5p significantly influenced HNSCC progression by regulating the PI3K‐Akt signaling pathway, in which the key target genes were upregulated in 519 HNSCC tissues compared to 44 normal tissues, as determined by the Gene Expression Profiling Interactive Analysis (GEPIA). In conclusion, our study may provide insights into the expression and mechanism of miR‐99a‐5p in HNSCC. Further studies are required to elucidate the role of miR‐99a‐5p and its potential clinical applications for HNSCC.

Scattered sarcomatoid urothelial carcinoma cells within MALT lymphoma of the urinary bladder

Recently the author encountered a peculiar tumour of the bladder consisting of the following three components: MALT lymphoma, scattered poorly cohesive sarcomatoid urothelial carcinoma within MALT lymphoma, and surface non-invasive, low-grade conventional urothelial carcinoma (UC) occurring in a 65-year-old female. A low-power view showed MALT. Meticulous observations revealed a small amount of non-invasive, low-grade conventional UC at the surface area. In addition, meticulous observations identified a small number of cytokeratin-positive, poorly cohesive sarcomatoid UC cells scattered within the MALT lymphoma. The MALT lymphoma was typical. Immunohistochemically, the scattered sarcomatoid cells within the MALT lymphoma were positive for various types of CK, EMA, p53 and Ki-67 (LI = 70%). The MALT lymphoma was composed mainly of B-cells (CD10, CD20, CD23, CD79α, κ-chains and λ-chain), but T-cells positive for CD3, CD4, CD5, CD43 or CD45RO were seen in a very small number. This scattering sarcomatoid UC within MALT lymphoma of bladder has not been reported.

Biphasic Squamoid Alveolar Renal Cell Carcinoma: A Distinctive Subtype of Papillary Renal Cell Carcinoma?

Biphasic squamoid alveolar renal cell carcinoma (BSARCC) has been recently described as a distinct neoplasm. Twenty-one cases from 12 institutions were analyzed using routine histology, immunohistochemistry, array comparative genomic hybridization (aCGH) and fluorescence in situ hybridization. Tumors were removed from 11 male and 10 female patients, whose age ranged from 53 to 79 years. The size of tumors ranged from 1.5 to 16 cm. Follow-up information was available for 14 patients (range, 1 to 96 mo), and metastatic spread was found in 5 cases. All tumors comprised 2 cell populations arranged in organoid structures: small, low-grade neoplastic cells with scant cytoplasm usually lining the inside of alveolar structures, and larger squamoid cells with more prominent cytoplasm and larger vesicular nuclei arranged in compact nests. In 9/21 tumors there was a visible transition from such solid and alveolar areas into papillary components. Areas composed of large squamoid cells comprised 10% to 80% of total tumor volume. Emperipolesis was present in all (21/21) tumors. Immunohistochemically, all cases were positive for cytokeratin 7, EMA, vimentin, and cyclin D1. aCGH (confirmed by fluorescence in situ hybridization) in 5 analyzable cases revealed multiple numerical chromosomal changes including gains of chromosomes 7 and 17 in all cases. These changes were further disclosed in 6 additional cases, which were unsuitable for aCGH. We conclude that tumors show a morphologic spectrum ranging from RCC with papillary architecture and large squamoid cells to fully developed BSARCC. Emperipolesis in squamoid cells was a constant finding. All BSARCCs expressed CK7, EMA, vimentin, and cyclin D1. Antibody to cyclin D1 showed a unique and previously not recognized pattern of immunohistochemical staining. Multiple chromosomal aberrations were identified in all analyzable cases including gains of chromosomes 7 and 17, indicating that they are akin to papillary RCC. Some BSARCCs were clinically aggressive, but their prognosis could not be predicted from currently available data. Present microscopic, immunohistochemical, and molecular genetic data strongly support the view that BSARCC is a distinctive and peculiar morphologic variant of papillary RCC.

Primary kidney parenchyma squamous cell carcinoma mimicking xanthogranulomatous pyelonephritis: A case report

Primary kidney parenchyma squamous cell carcinoma is extremely rare, and this is the forth case to be reported. In the present study, a case of a 61-year old man is discussed. The man presented with recurrent lumbago, gross hematuria for nearly 2 months, and suspicious inflammatory kidney diseases on contrast-enhanced computed tomography (CT) and fludeoxyglucose-positron emission tomography (FDG-PET)/CT, but a tumor can not be excluded completely prior to surgery. Finally, radical nephrectomy was performed, and histological analysis determined that the diagnosis was kidney parenchyma squamous cell carcinoma with inflammation invasion. The present case highlights the potential confusion of preoperative diagnosis of renal tumor with inflammation, and introduces the potential role of FDG-PET in its diagnosis and survival evaluation in renal malignancies.

Solitary skin metastasis from sarcomatoid carcinoma of the bladder: a case report

INTRODUCTION

Cutaneous metastases from carcinomas of the bladder are very rare. They are related to advanced stages of the disease and have poor prognosis with low survival rates. The common treatment modality of cutaneous metastases from a primary bladder cancer is wide local excision followed by chemotherapy.

CASE PRESENTATION

We report a case of solitary skin metastasis from a rare type of urinary bladder carcinoma in a 68 year-old Caucasian man. Urinary bladder carcinoma metastasizing to the skin is an uncommon finding despite the high incidence of this tumor. Skin metastasis generally presents in the late stages of this disease and indicates a poor outcome.

CONCLUSIONS

Because of the extremely aggressive malignant potential of sarcomatoid carcinomas, the indications for a transurethral resection of the bladder should be carefully assessed and suitable therapeutic strategies should be examined further.

Triple Synchronous Primary Gynecologic Carcinomas

Double synchronous primaries are known to occasionally occur in gynecologic cancers. Cases of triple or quadruple synchronous primaries, with only 4 case reports in the literature, are extremely rare. The authors report the case of a 49-year-old para 2-0-0-2 woman who presented for surgical management of metastatic ovarian adenocarcinoma diagnosed at an outside institution. On examination of the surgical specimen, 3 synchronous primary carcinomas with multiple histologic features were identified within the ovaries, uterus, and cervix. Although rare, the possibility of triple synchronous primary malignancies should be considered when evaluating gynecologic malignancies.